High-end specificity of the children's depression inventory in a sample of anxiety-disordered youth

Abstract

Using a receiver operating characteristic (ROC) analysis, the present study investigated the ability of the Children's Depression Inventory (CDI) to correctly detect depression in a sample of treatment-seeking anxious youth (N=44). The ADIS-C/P was used to determine diagnostic status of participants. Anxious children who met diagnostic criteria for a depressive disorder scored higher on the CDI than anxious children who did not meet criteria for a depressive disorder, supporting the CDI as a continuous measure of depressive symptomatology. In contrast, with regard to detecting a depressive disorder, CDI cut scores did not achieve favorable values across diagnostic utility indices (including the cut score of 13 that has been recommended). These findings support the CDI as a continuous measure of depressive symptoms, but do not support the CDI as a sole assessment for a diagnosis of depression within a sample of anxiety-disordered youth.

Screening for children’s depression symptoms in Greece: the use of the Children’s Depression Inventory in a nation-wide school-based sample

“…When the cutoff point of 13 was taken as threshold, the prevalence rate was somewhat higher (14.96%) than the prevalence figures of self-reported depressive morbidity obtained from studies in general population, but still much lower than those obtained from studies using the cutoff point of 13 of the CDI [17,43]. Since previous studies [10,24,27,48] indicate that CDI can be better used as a continuous measure of depressive symptoms [10] rather than as an accurate discriminatory (through cutoff scores) instrument for depression, further research using CDI along with other validated diagnostic measures for psychopathology in both clinical and nonclinical Greek populations (questionnaires and/or structured interviews) is needed. The particular cultural influences on children's depressive symptom reporting is an issue that should be further explored in future research in order to investigate whether lower mean cores in CDI (compared to studies in non-Greek populations) reflect lower rates of depressive symptoms, differences in the perception of the CDI items, or even cultural differences in the expression of depressive symptomatology.…”

“…The cutoff score of 19, corresponding to the 90th percentile, has been considered suitable for screening in the general population, while the cutoff score of 13, corresponding to the 65th percentile, has been suggested as being adequate for screening purposes in clinical samples [52]. However, with regard to clinical samples, there is a substantial body of research indicating that CDI cutoff scores cannot accurately distinguish between depressed and non-depressed individuals [10,24,27,48]. It has been shown that in clinical samples, CDI can be used as a preliminary continuous measure of depressive symptoms rather than a single evaluation instrument for a diagnosis of depression [10].…”

“…However, with regard to clinical samples, there is a substantial body of research indicating that CDI cutoff scores cannot accurately distinguish between depressed and non-depressed individuals [10,24,27,48]. It has been shown that in clinical samples, CDI can be used as a preliminary continuous measure of depressive symptoms rather than a single evaluation instrument for a diagnosis of depression [10].…”

Comorbid Depressive Disorders in Anxiety-disordered Youth: Demographic, Clinical, and Family Characteristics

“…Further research should examine differences between AD-DD and AD-NDD youth on the subscales of the CDI. If the current findings are replicated, use of only the negative mood, ineffectiveness, and anhedonia subscales may improve the ability of the CDI to detect depression in anxious youth, which is important given concerns about the high-end specificity of the CDI [39].…”

Diagnostic Efficiency of the Child and Adolescent Symptom Inventory (CASI-4R) Depression Subscale for Identifying Youth Mood Disorders

“…Therefore, for clinicians to be able to come to a more accurate assessment, it is important to use DLRs derived from similar settings (i.e., outpatient, inpatient, community mental health). The CDI is one of the few other measures that has been evaluated for distinguishing depressed youth from youth with anxiety disorders (Comer & Kendall, 2005), as well as referred youth with disorders other than depression (Timbremont, Braet, & Dreessen, 2004). A strength of our study was that we conducted analyses for data about youth recruited from outpatient clinical settings and used a comparison group composed of children who had a range of other disorders, making it more similar to what clinicians may experience in their practices.…”